The pathogenesis of male-pattern-baldness (MPB) is the same as acne. The first step in acne is a condition called follicular-hyperkeratinization or hyperkeratosis. Simply put, this means excess skin production inside and around the hair-follicle. The next step is caused by excess sebum production, followed by P.Acnes infestation of the pilosebaceous-follicle, with subsequent inflammation. So to summarize, MPB, just like acne, is caused by four main factors: (1) follicular-hyperkeratinization, (2) excess sebum production, (3) P.Acnes, and (4) inflammation [1].

Free-IGF-1 (insulin-like-growth-factor-1) stimulates the proliferation of keratinocytes (skin cells below the scalp). As the keratinocytes mature, they migrate to the top of the scalp and become what is known as corneocytes. If all goes well, the corneocytes are supposed to be shed off the scalp in a process called apoptosis. The shedding of corneocytes or the apoptosis of corneocytes, is under the influence of IGFBP-3 (insulin-like-growth-factor-binding-protein-3) and endogenous retinoids. In men with male-pattern-baldness, they have excess free-IGF-1 and not enough IGFBP-3 [2]. The result of this is hyperkeratinization; too much skin production, and not enough skin exfoliation. This causes the hair-follicle to be blocked by excess skin. Free-IGF-1 is required for keratinocyte proliferation in humans [3] and too much IGF-1 results in hyperkeratosis [4].

Free-testosterone stimulates sebum production by converting into DHT (dihydrotestosterone) within the sebaceous-glands. Both insulin and free-IGF-1 can not only stimulate the synthesis of androgens from testicular-tissue [5] [6], but high levels of both insulin and free-IGF-1 also inhibit the livers production of SHBG (sex-hormone-binding globulin) [7] [8]. SHBG is shown to be lower in men and woman with androgenic-alopecia (MPB) [9-13]. As SHBG goes up, free-testosterone goes down. As free-testosterone goes down, less is available to be converted into DHT. With less DHT comes less sebaceous-activity.

So far I have shown that a lack of IGFBP-3 (and excess free-IGF-1) causes hyperkeratinization of hair-follicles. And that low levels of SHBG promote excess sebum production. Next, after combining these two scenarios, we get P.Acnes infiltration. You see, the excess skin is now blocking not only the hair-follicle from sprouting out of the scalp, but now, also the flow or excretion of sebum. As a consequence, the sebum builds-up within the pilosebaceous-follicle. With this anaerobic-environment caused by the hyperkeratosis and with all this trapped excess sebum, the situation becomes the perfect breeding ground for a bacterium named P.Acnes, which feeds off the trapped sebum. The body is smart and the immune-system detects these nasty critters and attacks them with inflammation [14]. This explains why Nizoral-shampoo seems to be effective in controlling the symptoms of MPB [15]. The active ingredient in Nizoral-shampoo is ketoconazole, which has been shown to kill P.Acnes [16].

The solution to this cascade of events, would be to obviously lower your free-IGF-1 activity. Lowering free-IGF-1 would, (1) decrease the IGF-1:IGFBP-3 ratio, and (2) increase SHBG, thus preventing hyperkeratinization of the hair-follicles and excess sebum production. Preventing hyperkeratosis and sebum production would prevent P.acnes infestation and the subsequent inflammation that follows.

So how does one lower free-IGF-1 levels? Studies are consistent in showing that a vegan-diet causes both a decrease in IGF-1 and an increase in SHBG [17-31]. Many of these studies indicate that vegans have higher SHBG and lower IGF-1 despite the fact they are consuming high-fat diets, like eating lots of nuts or avocados. I personally believe that an extremely-low-fat vegan diet is optimal, due to the fact that dietary-fat causes insulin-resistance. Insulin-resistance causes high-insulin and IGF-1 in the blood. I also believe that fructose should be limited as much as possible. Fructose readily converts into fat in the liver, in a process called de-novo-lipogenesis and once again, fat paralyzes insulin-action, thus keeping it in the blood for extended periods of time, instead of driving glucose into the cells. Animal-protein, especially protein from dairy-products, rich in methionine, casein, and essential amino-acids seems to be the best stimulator of IGF-1. This explains why vegan-diets, low in "high-quality" protein increase SHBG and decrease IGF-1 regardless of fat content. With that stated I personally believe with all of my heart, that you would get the best results with a diet consisting only of beans, whole-grains and vegetables. Nuts and fruit (fat and sugar) should be eaten rarely.

Avoiding dairy-products is of huge importance! Nothing increases free-IGF-1 more than dairy-products; this has been consistently shown over and over again in the scientific-literature. And this should come as no surprise, considering the purpose of milk is to stimulate rapid-growth, development and maturity of the newborn. Dairy-products also contain DHT precursors [32] [33] and potent estrogens [34-36].

After over 30 years of nutritional dogma barking over and over again that "diet has nothing to do with acne". Recent research has proven beyond a doubt, that diet does affect acne and that dairy-products and high-fat, sugar-laden processed-food are the largest culprits [37-45]. And since the pathology of MPB and acne are identical, any type of diet that promotes acne has the potential to promote MPB in genetically-predisposed people.

Eating a low-fat, low-fructose, high-fiber vegan-diet high in complex-carbohydrates should stop the progression of MPB hormonally. However this is unlikely to get rid of all the follicular-hyperkeratinization that has already occurred over time. To reverse hyperkeratosis, exfoliate the scalp and regrow "lost" hair, I highly suggest using glycolic-acid topically. Glycolic-acid is what's called an alpha-hydroxy-acid. Alpha-hydroxy-acids are shown to diminish corneocyte cohesion, induce exfoliation and reverse hyperkeratosis [46]. This should promote regrowth. I've been using glycolic-acid since the beginning of the year (along with my complex-carbohydrate-vegan-diet), I have removed a copious amount of dead-skin-cell "build-up" from my scalp. Nearly three-grams of dead-skin so far! And my hair has drastically thickened! I'm completely convinced this is the correct way to combat MPB.

So to rehash or recap everything said here: a high level of free-IGF-1 (caused by eating a high-fat, high-protein, rich western-diet) causes follicular-hyperkeratinization and down-regulation of SHBG. Low SHBG correlates with the metabolic-syndrome [47-51] and promotes excess sebum production. Excess sebum is trapped, along with the hair-follicle, beneath the excess skin (produced by over-expression of IGF-1), this gives rise to P.Acnes; a bacterium that feeds off sebum and generates inflammation from the immune-system. Eating a diet consisting of beans, whole-grains and vegetables will drastically decrease IGF-1 and increase SHBG, preventing any further progression of MPB. Glycolic-acid used topically will reverse the hyperkeratosis already present and promote regrowth.

I would also like to close by saying that the effects of the complex-carbohydrate-vegan-diet can be magnified by practicing intermediate-fasting, exercise, getting plenty of sunshine exposure on the body and drinking nothing but water and organic-green-tea.

misterE wrote: To properly apply the AHA's, you have to shave your head... because having hair (even short-hair), makes it difficult for the AHA to penetrate the scalp. After I shave my head, I apply AHA's to my scalp and try and leave it on for a full 24-hours. The next morning, I take a shower and wash the AHA off my scalp, I do not towel dry my scalp, I let it air-dry naturally. An hour or two later I comb my scalp and remove massive amounts of dead-skin that has accumulated over my hair-follicles. Each time, my hair grows thicker and thicker, I repeat this process every 5 to 6 months. The results are truely amazing!

I ordered the Skin Laboratory level 1 glycolic acid, 300 ml. I did the first application yesterday. I'm skeptical, but I'm willing to be a guinea pig. Shaved my head... that's a weird sensation... and used the peel. Got a bit of a tingle out of it.

Only thing is, I'm curious about you saying you try to leave it on for a full 24 hours. The directions for application time clearly state, in bold letters, Do not exceed 8 minutes. What is your reasoning for leaving it on 24 hours?

rickfm wrote:Only thing is, I'm curious about you saying you try to leave it on for a full 24 hours. The directions for application time clearly state, in bold letters, Do not exceed 8 minutes. What is your reasoning for leaving it on 24 hours?

To let it penetrate better. The tingling that you mention is a sign of exfoliation. Did you notice large amounts of dead-skin peeling off; did you exfoliate manually (using a comb to comb your scalp, the day after applying the glycolic-acid)? What percentage-peel did you get?

No, I didn't manually exfoliate. Do you really use a comb? That seems a bit harsh. I have a stiff bristle brush.

I basically followed the directions for my first application. Tested it on a small patch of my forearm for reaction, applied to scalp, let sit for 8 minutes, rinse with copious amounts of water, pat dry with paper towel.

The only thing I didn't do, which the directions list as IMPORTANT, was to apply a non-comedogenic moisturizer with SPF 30 or higher. I figured that the product is normally used on the face and that is for added protection against sensitivity. Being winter now I always wear a knit cap when I'm outside anyhow.

My scalp is normally flaky. I use a dandruff shampoo regularly. I'm hoping that the McD plan will help with that. I suppose if this peel even helped to improve that it would be a benefit even if I don't see new hair growth. Time will tell I guess. I'll try the manual exfoliation next week.

de-novo-lipogenesis, McDougall has discussed this as something that is so inefficient it would take massive amounts of calories for months to turn enough into a lb of fat. If you do a search on it you can probably find the stats/data

rickfm wrote:No, I didn't manually exfoliate. Do you really use a comb? That seems a bit harsh. I have a stiff bristle brush.

I basically followed the directions for my first application. Tested it on a small patch of my forearm for reaction, applied to scalp, let sit for 8 minutes, rinse with copious amounts of water, pat dry with paper towel.

The only thing I didn't do, which the directions list as IMPORTANT, was to apply a non-comedogenic moisturizer with SPF 30 or higher. I figured that the product is normally used on the face and that is for added protection against sensitivity. Being winter now I always wear a knit cap when I'm outside anyhow.

My scalp is normally flaky. I use a dandruff shampoo regularly. I'm hoping that the McD plan will help with that. I suppose if this peel even helped to improve that it would be a benefit even if I don't see new hair growth. Time will tell I guess. I'll try the manual exfoliation next week.

Any update on this ?I'm interrested in doing this same regimen, simply because it makes a lot of sense to me.I wouldnt be surprised if my head was all clogged up with dirty dead skin. However, don t you damage/kill ure hair folicles if u manually remove the stuff?Also to misterEE waht % lotion, is needed, and is it dangeorus to leave on 24h?

Yes. I have upgraded to TCA (trichloroacetic acid) 50% recently. It burns beyond belief, but it exfoliates very well. Instant frosting! It is hard to believe how much dead skin (hyperkeratinization) I have on my head!

Surprisingly not! Ever since I began eating nothing but grains, beans, vegetables and drinking only water or organic green-tea, my hair-loss completely stopped. I know it sounds counterintuitive, but it's the only thing that will penetrate the thick layer of corneocytes that are literally blocking the growth of hair.

A few days after the peel has no longer become tender, start exfoliating with a nylon-bristle-brush! Watch how much exfoliation you get!

yyyounes wrote:

waht % lotion, is needed, and is it dangeorus to leave on 24h?

Get one bottle of glycolic-acid-35%, use that, then move to glycolic-acid-50%, after that I would move to maybe TCA-25% then TCA-50%... but nothing beyond! Each peel will penetrate deeper and deeper until eventually all the excess corneocyte build-up has been desquamated.

Unfortunately, no. And sorry for not replying sooner. I've only recently started participating in this forum again.

I'm terrible at sticking with things that require routine treatment. I never was able to follow through on this so I can't say anything one way or the other. I am still curious about it, though. I may give it another go soon.

Great post..very informative...however where did you get all the information from? Are you a doctor, scientist? Did someone else come up with it? There are just to many terms in the post for the ordinary person to be familiar with them. I don't mean to be cynical at all, I am just curious though.

Once again, it sounds great and thanks for the information. I think I might try it, (except for the shaving the head part)

Also, where does one purchase Alpha Hydroxy-Acid (gylcolic acid)????And where can someone buy Nizoral-shampoo?

I am suffering from MPB and lately i've been experiencing a severe ich on my scalp. I read somewhere the 'ich' could be little hair follicles dying. I put olive oil on my scalp last night and washed 30 minutes later and that seemed to put the ich away.

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